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Biomedical subjects

V Shantaram

Publications and source records attributed to V Shantaram.

9 recordsLinked to original sources
PubMed2000

Clinical profile of falciparum malaria in a tertiary care hospital.

Falciparum malaria presents with protean manifestations and is associated with a variety of complications and has a high mortality. One hundred and fifty-eight consecutive cases of falciparum malaria were studied with respect to the clinical presentation, complications, and response to treatment. The mean age of patients was 38.60 +/- 15.45 years and majority of them were males i.e., males being 110 (69.62%) and females being 48 (30.37%). The commonest presenting manifestations were fever with chill and rigor (98.10%), altered sensorium (48.10%), algid malaria (18.35%), and jaundice (27.21%). The other presenting features being oliguria (6.96%) and bleeding manifestations due to disseminated intravascular coagulation (DIC) (4.43%). The frequently encountered complications were anaemia (74.68%), jaundice (40.50%), cerebral malaria (45.56%), thrombocytopenia (40.50%) and renal failure (24.68%). Most of the patients i.e., 126 (79.74%) recovered with treatment and 32 (20.25%) succumbed. Higher mortality was associated with higher parasite count, presence of complications like anaemia, jaundice, renal failure, DIC, adult respiratory distress syndrome (ARDS), and septicaemia. Most of the deaths were encountered in patients where there was delay in clinical diagnosis, in the pre-hospital phase, and consequent presentation in multiorgan failure. Early diagnosis and institution of specific therapy were rewarding in the remaining patients in this series.

Adult↗
PubMed1999

Malignancy in rheumatoid arthritis--a report of two cases.

The development of malignancy in the setting of pre-existing connective tissue disease is well known. We report two cases of rheumatoid arthritis who developed malignancy--multiple myeloma in one of them and carcinoma cervix in the other. Case 1 was a 62 year old man, who developed multiple myeloma three years after the onset of rheumatoid arthritis. Case 2 was a 61 year old female with history of rheumatoid arthritis for two years and who developed carcinoma cervix.

Arthritis, Rheumatoid↗
PubMed1998

Human immunodeficiency virus infection in a tertiary care hospital--clinical and microbiological profile.

Infection with the Human Immunodeficiency Virus (HIV) has an increasing, direct and significant impact on the hospital, especially the emergency services. Out of a total of 39,876 patients screened, 1061 patients were reactive for anti-HIV antibodies. The incidence of the infection showed a remarkable progression from 0.89% in 1992-1993 to 5.6% in 1997, among the seropositive patients. The number of patients with signs and symptoms related to HIV infection has also shown a 2 fold rise (from 42% in 1992-1993 to 87% in 1997). The prevalence of HIV 1 in the seropositive patients is 93%, HIV 2 alone is 2.3% and 3.1% had a mixed infection with both HIV 1 and 2. Secondary infection with Mycobacteria ranked high (25%) among the symptomatic patients, with pulmonary and the disseminated varieties being more common.

Adolescent↗
PubMed1995

Comparison of phenytoin with auranofin and chloroquine in rheumatoid arthritis--a double blind study.

OBJECTIVE: To evaluate efficacy of phenytoin in modifying the course of rheumatoid arthritis (RA) by comparing it to gold (auranofin) and chloroquine. METHODS: A double blind, randomized study of 6 months' duration was conducted at the Nizam Institute of Medical Sciences, Hyderabad, India. One hundred and thirty-two patients with active RA (defined by the 1987 ARA criteria) were entered into the study and randomized into 3 groups: phenytoin, chloroquine, or auranofin. RESULTS: Full data were evaluable in 100 patients who satisfactorily completed the protocol (phenytoin, 35; auranofin, 30; and chloroquine, 35). Twenty-four patients were noncompliant and did not take medication or return for evaluation; 8 patients had the drug withdrawn because of side effects before study completion. For each of the 3 drugs all clinical and laboratory variables improved when pre and posttreatment values (p < 0.05 to 0.001) were compared. There was a greater reduction in posttreatment mean morning stiffness in the chloroquine group than in the phenytoin and auranofin groups (p < 0.05). Posttreatment grip strength was also greatest in the chloroquine group. On the other hand, there were statistically significant decreases in IgM levels in both the phenytoin and auranofin groups (p < 0.001), but not with chloroquine. Among the 53 patients with a disease history of 3-6 months, global outcome was best with phenytoin (16/17), compared to chloroquine (12/18) and auranofin (12/18) (p < 0.03). However, there was no such difference in the 47 patients in all 3 groups with a disease history longer than 6 months. Eight patients had side effects (phenytoin, auranofin, 2; chloroquine, 1) requiring withdrawal of the drug. However, the incidence of side effects was not significantly different for the 3 drugs. CONCLUSION: Our data indicate that phenytoin is comparable to auranofin and chloroquine in its efficacy in RA and may be considered an alternative disease modifying agent for RA.

Adult↗
PubMedDate not supplied

Pathogenesis of atherosclerosis in diabetes and hypertension.

Prevalence of atherosclerotic vascular disease is markedly increased among individuals with diabetes-mellitus and hypertension. Its major clinical manifestations are consequences of atherosclerosis of coronary arteries, cerebral arteries and large arteries of lower extremities. Thus, atherosclerotic vascular disease is the major cause of mortality and significant morbidity in diabetes and hypertension. Dyslipidemia, hyperinsulinemia, and central obesity seem to be associated with increased risk of atherosclerosis, along with the development of hypertension and diabetes (NIDDM). Insulin resistance is the fundamental factor in this situation which has strong genetic predisposition. Accelerated atherosclerosis in diabetes due to mechanism unique to diabetes like non-enzymatic glycation of proteins, oxidative modification of lipoproteins, formation of lipoproteins immune complexes, lipoproteins aggregation, disturbances of cell replication and growth factors and propensity to thrombosis are clearly established. Therapeutic implication for the prevention of atherosclerosis in diabetes and hypertension clearly emphasizes the need to achieve tight control of hyperglycemia, hypertension, and hyperlipidemia in addition to avoiding cigarette smoking and developing obesity.

Arteriosclerosis↗
PubMedDate not supplied

Hepatitis in falciparum malaria.

BACKGROUND: Hepatocellular jaundice occurring in patients with falciparum malaria has been called as malarial hepatitis. METHODS: We studied 95 consecutive patients admitted with falciparum malaria. Of these 20 had evidence of malarial hepatitis. Their clinical presentation, complications and response to treatment was compared with that of patients without evidence of malarial hepatitis. RESULTS: The clinical presentation of these patients was not different from those without hepatitis. However, the incidence of complications such as renal failure (60% vs 25%; X2 = 8.47, p < 0.01), Adult Respiratory Distress Syndrome (35% vs 3%; X2 = 18.13, p < 0.001) and septicemia (20% vs 6%; X2 = 4.01, p < 0.05) was significantly higher. The mortality also was higher in the group of patients with malarial hepatitis (40% vs 17%; X2 = 4.85, p < 0.05). CONCLUSIONS: We conclude that the presence of hepatitis in patients with falciparum malaria indicates a more severe illness with a higher incidence of complications and a poor prognosis.

Adolescent↗